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EP1366733A2 - Prothèse vertébrale - Google Patents

Prothèse vertébrale Download PDF

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Publication number
EP1366733A2
EP1366733A2 EP03253292A EP03253292A EP1366733A2 EP 1366733 A2 EP1366733 A2 EP 1366733A2 EP 03253292 A EP03253292 A EP 03253292A EP 03253292 A EP03253292 A EP 03253292A EP 1366733 A2 EP1366733 A2 EP 1366733A2
Authority
EP
European Patent Office
Prior art keywords
prosthesis
bearing
bearing element
distal
proximal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP03253292A
Other languages
German (de)
English (en)
Other versions
EP1366733A3 (fr
Inventor
Alistair Gibson
James William Truscott
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Biomet UK Ltd
Original Assignee
Biomet Merck Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Biomet Merck Ltd filed Critical Biomet Merck Ltd
Publication of EP1366733A2 publication Critical patent/EP1366733A2/fr
Publication of EP1366733A3 publication Critical patent/EP1366733A3/fr
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30426—Bayonet coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649—Ball-and-socket joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2002/4631—Special tools for implanting artificial joints the prosthesis being specially adapted for being cemented
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements

Definitions

  • This invention relates to a spinal prosthesis, and particularly, although not exclusively, relates to a spinal prosthesis which is used to replace a vertebral body, such as a cervical disc.
  • the cervical spine is a complex anatomic structure, consisting of seven vertebrae supported by ligaments, muscles and intervertebral discs. There are two atypical vertebrae, C1 and C2, which differ in structure and function from all the other vertebrae of the spine.
  • the five typical vertebrae have features similar in form to all the other vertebrae of the spine. That is, they have an anterior body, articular and spinous processes, an intervertebral foramen, and superior and inferior facet joints.
  • the anterior bodies also have lateral buttresses, the unciform processes, which largely restrict motion to flexion and extension.
  • These vertebrae also have transverse foramen which are pathways for the vertebral arteries.
  • the relative positions of the vertebrae are maintained principally through the anterior and posterior longitudinal ligaments, which lie anterior and posterior to the vertebral body, and the facet joints.
  • the spinous processes are linked by the interspinous ligaments, and the transverse processes are linked by the intertransverse ligaments.
  • the facet joints, true synovial joints, are inclined at approximately 45 degrees. They serve to guide motion between the levels, but do not constrain it.
  • the intervertebral discs are interposed between the endplates of adjacent vertebrae. Their principal functions are to withstand compression loads and restrain excessive motion. They are comprised of two major elements, the nucleus pulposus and annulus fibrosis.
  • the nucleus pulposus is a gelatinous mass at the core of the disc and functions as a load bearing shock absorber.
  • the annulus fibrosus is a fibrous outer ring surrounding the nucleus. Fibers of the annulus are woven into the outer ring of the adjacent body endplates, and withstand shear and torsional loading.
  • the cervical portion of the vertebral column possesses the highest degree of mobility, and is the most susceptible to functional stress, trauma, and degenerative arthritic diseases. Symptoms of cervical disc degeneration include nerve root entrapment concomitant with loss of function, pain, and possible disability. Vertebral artery insufficiency may result from osteophytes impinging at the intervertebral foramen.
  • Treatment of these conditions involves surgical removal of diseased bony material and fusion of the anterior bodies at the levels involved. This enforced partial column rigidity often induces high loading concentrations at adjacent levels, and accelerated decrepitude. Furthermore, the range of movement in the treated area is greatly reduced.
  • a prosthesis for replacing a part of a human or animal spine comprising a first element which is adapted to be connected to a first vertebra and a second element which is adapted to be connected to a second vertebra, the first element being capable of articulation relative to the second element in vivo.
  • the prosthesis further comprises a bearing element which is interposed between the first and second elements in vivo.
  • the bearing element may be attached to the first element, and the second element may have a bearing surface which engages a cooperating wear surface of the bearing element.
  • the wear surface of the bearing element and the bearing surface of the second element are preferably shaped to reduce the likelihood of dislocation.
  • the wear surface of the bearing element may be convex and the bearing surface of the second element may be concave.
  • the wear surface of the bearing element may be concave and the bearing surface of the second element convex.
  • the first and second elements are preferably made from stainless steel or titanium.
  • the bearing element is preferably made from ultra high molecular weight polyethylene.
  • Cooperating formations may be provided on the bearing element to engage cooperating formations on the first element.
  • the bearing element may be fixed permanently to the first element.
  • it may be compression moulded onto the first element.
  • a plurality of bearing elements of different dimensions may be provided; each bearing element may be fixed to a different first element or may be selectively engagable with a common first element.
  • the first element and the second element are cast of a bio-compatible high strength material such as steel or titanium, or an alloy such as a cobalt-chromium-molybdenum alloy or other suitable material.
  • the first and/or second elements are provided with raised projections which are adapted to be secured in bone.
  • these projections may be adapted for cemented fixation within the vertebrae.
  • they may be provided with an hydroxyapatite coating to facilitate bone growth in this region.
  • references to the "proximal” element relate to the element closest to the head of the patient, in vivo, and references to the “distal” element refer to the element furthest from the head of the patient, in vivo.
  • a vertebral prosthesis 1 in accordance with the present invention comprises a distal element 2 which is attached to a bearing element 4 and articulates with a proximal element 5.
  • the distal element 2 comprises an oval shaped tray 8 which is integrally formed with a vertebral, stem 6.
  • the vertebral stem 6 extends from the centre of a distal surface 10 of the tray 8 in a direction substantially perpendicular to the distal surface 10 of the tray.
  • the distal element 2 has a side wall 12 which defines the periphery of the tray 8.
  • the bearing element 4 is secured to the proximal end of the distal element 2 and has a side wall 18, which is aligned with the side wall 12 of the distal element 2.
  • the proximal face of the bearing element 4 comprises a convex bearing surface 32.
  • connection means 22 for connecting the distal element 2 to the bearing element 4.
  • the connection means 22 comprises a circumferential groove 24 which is disposed around the distal element 2.
  • Proximal to the groove 24 is a circumferential lip 28 which projects laterally from the distal element 2.
  • the lip 28 has a side wall 30 extending around its periphery.
  • the side wall 30 of the lip 28 is interrupted by four equidistantly spaced recesses 50a-d.
  • a proximal element 5 is illustrated in Figures 6 to 8. It comprises an oval shaped tray 46 having a concave bearing surface 42 situated on its distal face. A vertebral stem 48 extends perpendicularly away from a centre of the proximal face of the tray 46.
  • the tray 46 includes a side wall 47 which extends around the circumference of the tray 46 and has a bevelled distal edge 44.
  • a surgeon removes damaged tissue, such as a cervical disc and drills anchorage holes in adjacent faces of the vertebrae which abut the damaged disc.
  • the vertebral stem 6 of the distal element 2 is fixed in the anchorage hole in one of the vertebrae, and the vertebral stem 48 of the proximal element 5 is fixed in the anchorage hole in the other vertebra.
  • Bone cement may be used to secure the vertebral stems 6, 48 in position.
  • the oval trays 8, 46 of the distal and proximal elements 2, 5 are aligned such that their greatest width lies along a medio-lateral axis of the human body, and their least width lies in the saggital plane. Furthermore, the concave surface 42 of the proximal element 5 engages the convex surface 32 of the bearing element 18 in a load bearing manner. The concave bearing surface 42 is thus superior to the convex bearing surface 32, in vivo.
  • the prosthesis 1 allows the vertebrae to which it is connected to rotate relative to one another to a certain degree, around medial-lateral and anterior-posterior axes.
  • the prosthesis also allows relative rotation of the vertebrae about a longitudinal axis of the spine.
  • Load bearing stability of the prosthesis is provided by the surrounding muscle tissue, but is enhanced by the self centring action of the concave bearing surface 42 and convex bearing surface 32.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
EP03253292A 2002-05-27 2003-05-27 Prothèse vertébrale Withdrawn EP1366733A3 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0212150 2002-05-27
GB0212150A GB2389046B (en) 2002-05-27 2002-05-27 Spinal prosthesis

Publications (2)

Publication Number Publication Date
EP1366733A2 true EP1366733A2 (fr) 2003-12-03
EP1366733A3 EP1366733A3 (fr) 2004-07-28

Family

ID=9937475

Family Applications (1)

Application Number Title Priority Date Filing Date
EP03253292A Withdrawn EP1366733A3 (fr) 2002-05-27 2003-05-27 Prothèse vertébrale

Country Status (2)

Country Link
EP (1) EP1366733A3 (fr)
GB (1) GB2389046B (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007016037A3 (fr) * 2005-07-27 2007-06-14 Univ Texas Procedes de transdifferenciation de cellules

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5314477A (en) * 1990-03-07 1994-05-24 J.B.S. Limited Company Prosthesis for intervertebral discs and instruments for implanting it
FR2718635A1 (fr) * 1994-04-15 1995-10-20 Axcyl Medical Prothèse cervicale.
WO2001001893A1 (fr) * 1999-07-02 2001-01-11 Spine Solutions Inc. Implant intervertebral
US6368350B1 (en) * 1999-03-11 2002-04-09 Sulzer Spine-Tech Inc. Intervertebral disc prosthesis and method

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB9125798D0 (en) * 1991-12-04 1992-02-05 Customflex Limited Improvements in or relating to spinal vertebrae implants
US5425773A (en) * 1992-01-06 1995-06-20 Danek Medical, Inc. Intervertebral disk arthroplasty device
FR2694882B1 (fr) * 1992-08-24 1994-10-21 Sofamor Prothèse discale intervertébrale.
US5676701A (en) * 1993-01-14 1997-10-14 Smith & Nephew, Inc. Low wear artificial spinal disc
FR2724109A1 (fr) * 1994-09-05 1996-03-08 Medinov Sa Prothese rachidienne intervertebrale a glissement notamment cervicale
IL134387A0 (en) * 1997-08-04 2001-04-30 Gordon Maya Robert & Thomas Nu Multiple axis intervertebral prosthesis

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5314477A (en) * 1990-03-07 1994-05-24 J.B.S. Limited Company Prosthesis for intervertebral discs and instruments for implanting it
FR2718635A1 (fr) * 1994-04-15 1995-10-20 Axcyl Medical Prothèse cervicale.
US6368350B1 (en) * 1999-03-11 2002-04-09 Sulzer Spine-Tech Inc. Intervertebral disc prosthesis and method
WO2001001893A1 (fr) * 1999-07-02 2001-01-11 Spine Solutions Inc. Implant intervertebral

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007016037A3 (fr) * 2005-07-27 2007-06-14 Univ Texas Procedes de transdifferenciation de cellules

Also Published As

Publication number Publication date
GB2389046B (en) 2005-10-05
EP1366733A3 (fr) 2004-07-28
GB2389046A (en) 2003-12-03
GB0212150D0 (en) 2002-07-03

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